Gynaecomastia

Male Breast Reduction

Common in men of any age, gynaecomastia is simply the excessive enlargement of the male breast.

The development of extra breast tissue can occur in one or both breasts for a number of reasons. It is often the result of hormonal changes such as puberty, metabolic changes, weight gain, hereditary conditions, other health problems or certain medications, like steroids.

For many, there is no known cause. Boys who develop gynaecomastia during their adolescent years may grow out of it by their 20s, while older men may find it getting worse.

Excess breast tissue can cause sagging and stretch the areola (the dark skin surrounding the nipple). Although this condition is quite common, many men find gynaecomastia to cause emotional distress and might consider male breast reduction surgery.

In some cases, gynaecomastia may be improved by non-surgical treatments, such as changing medication or treating the cause of the abnormal hormone levels. For others, male breast reduction surgery to remove the extra tissue may be more appropriate.

Men with gynaecomastia have an excess of fatty tissue, glandular tissue or both — extra or loose skin may also make the breast area look bigger.

The type of surgery required will depend largely on the type of tissue you have. Fatty tissue can be removed by liposuction, while glandular tissue needs to be surgically removed. A combination of fatty and glandular tissue requires a combined approach.

Individual factors and personal preferences will help you and Dr Lim to determine the surgical approach most suitable for you. The incisions for liposuction and glandular tissue removal are very small, however, if the removal of excess tissue or skin is required the incisions will be larger.

Dr Lim will do his best to minimise scarring — how much tissue is to be removed, the type and length of incision required, and exactly where incisions will be made will be discussed with you in the consultation process.

Male breast reduction for gynaecomastia is individually customised to each patient depending on their personal requirements — during the consultation period, Dr Lim will take you through all available options and possible outcomes.

The procedure may take one to two hours and is performed under general anaesthetic in an accredited hospital. Depending on the type of surgery and the amount of fat to be removed, you may be discharged on the day of the surgery or you will be required to stay in hospital overnight.

If you have both glandular and fatty tissue removed, drainage tubes may be required to drain away any excess fluid that can accumulate after surgery. Dr Lim will review you post-operatively and determine when the drains can be removed and how long you need to stay at the hospital. You will be prescribed analgesia and antibiotics for you to continue at home.

My Klinik staff will stay in touch with you after the procedure, monitor your progress and answer any questions or concerns as they arise. You’ll have reviews with Dr Lim one week, one month and three months after surgery.

Our goal is to make your experience as easy and comfortable as possible — Dr Lim and the My Klinik staff are always willing to answer any questions you may have.

Pre and Post-Operative Care

  • You must fast prior to your procedure — do not eat, drink (even water) or chew anything for at least six hours before your procedure. The hospital will ring you the day before your procedure to confirm your admission time.
  • If you have a gastric band or sleeve, you will need to have a fluid diet the day before your surgery and fast for at least eight hours on the day of your procedure.
  • Notify Dr Lim of any medications that you are currently taking.
  • Do not take any medication that contains aspirin, or any anti-inflammatory or herbal medication for two weeks before your procedure. Aspirin thins the blood, which can result in unnecessary blood loss during your procedure.
  • Do not smoke for four weeks before and four weeks after your procedure. Smoking decreases blood flow to the skin and may delay the healing process.
  • Do not drink any alcohol for two days before and two days after your procedure as it can interfere with the anaesthetic you will be given on the day.
  • Vitamin C may help reduce your healing time and is recommended for two weeks before and two weeks after surgery.
  • Do not wear any nail polish, make-up or jewellery to the hospital and leave any valuables at home.
  • You will need a comfortable, loose shirt that buttons at the front to wear home from the hospital, so you don’t need to lift your arms.
  • Dr Lim will normally visit you in the hospital following your procedure or the morning after if you are staying overnight.
  • When you wake up you will have a firm bandage around your chest and you may have a drain in each side of your chest. The drains will be removed after one to two days, or when the amount of drainage fluid has reduced.
  • General anaesthetic can take a few days to recover from — it can be quite normal to feel a little slow or out of sorts for a few days.
  • It is crucial that you finish the course of antibiotics you are prescribed to prevent any post-op infection. Dr Lim will also prescribe oral pain relief — please contact My Klinik if this doesn’t control your pain.
  • You will be required to wear a post-operative compression garment day and night for the first three weeks, and at night for the following three weeks.
  • Do not lift anything heavy for three to four weeks and avoid sporting activities for four to six weeks.
  • Dr Lim will remove the tape over your incision sites at your one-week post-op checkup.
  • You may start applying vitamin E cream or oil to your scars a week after this tape is removed. This will help with healing and is recommended twice a day for three months. You may also like to apply silicone sheeting, which Dr Lim will advise you on.
  • Do not use spray tan on the suture lines for at least six weeks.
  • Do not smoke during your recovery period as this may slow the healing process and affect wound healing.
  • My Klinik nursing staff will contact you to make sure that you are feeling comfortable and to confirm your one-week post-op checkup with Dr Lim.
  • Contact My Klinik if any of the following develop:
    • A temperature higher than 38°C or chills
    • Heavy bleeding or fluid from any incision or drain site
    • Increased pain in either side of the chest
    • Redness around the incisions that is spreading
    • Tenderness and marked enlargement of either side of the chest.
  • Dr Lim and the nursing staff are available to you as you recover — should you have any concerns or questions, please don’t hesitate to contact My Klinik. For after-hours concerns, please contact the hospital where you had your surgery and they will be able to contact Dr Lim as required.

Gynaecomastia FAQs

Male breast reduction surgery may be right for you if you:

  • Have tried other medical or non-surgical treatments for gynaecomastia but these haven’t worked
  • Feel self-conscious about the appearance of your chest, and/or
  • Experience discomfort such as tenderness or pain in your chest.

Surgery may be discouraged in men who are overweight and have not tried proven weight loss techniques such as diet and exercise. Men may be required to cease excess use of alcohol, marijuana and anabolic steroids before surgery will be considered, as excess use of these drugs can be a cause of gynaecomastia.

As with most surgical procedures, surgery for gynaecomastia is best suited for patients in good physical health, who don’t smoke and who have realistic expectations about the outcome of the surgery.

Individual factors and personal preferences will help you and Dr Lim to determine the most appropriate procedure for your situation. The type of surgery performed will depend largely on the type of tissue causing your gynaecomastia.

To remove fatty tissue, liposuction may be the best course of action. During this procedure, a slim hollow tube called a cannula is inserted through one or more small incisions. The cannula is moved through the tissue using firm strokes to break up the fatty tissue which is then suctioned away.

If the tissue is glandular, a small cut is made at the lower edge of the areola and may be extended onto the skin. The gland tissue is then dissected away and removed.

If there is associated excess skin, a skin tightening procedure may also be required to give a firm, flat result.

Dr Lim will discuss with you the best method and the required incisions for your desired outcomes during the consultation process.

Your first consultation with Dr Lim will take around 45 minutes and you are most welcome to bring a support person with you. Due to social distancing measures as a result of COVID-19, the support person may not be able to enter the rooms (depending on the number of persons in the rooms at that particular time).

Dr Lim will take the time to discuss the procedure with you, the changes you desire, and any other issues that you feel are important to you. This will help Dr Lim understand your expectations and determine if they are achievable.

Dr Lim will explain the risks of surgery and discuss the methods of surgery for gynaecomastia with you. Your chest will be assessed, and a few measurements and photographs will be taken to plan the procedure.

You do not have to make the decision to proceed with the surgery at this initial consultation. You will be given a written quotation and information to take home to read.

Dr Lim will examine your chest and assess the type of tissue requiring removal. He may request you get further tests to find the reason for your gynaecomastia if required.

Please come to the consultation prepared to discuss your medical history. This will include information about any medical conditions you have, medications you are currently taking, allergies you have, other medical treatments you have received and any previous surgery you have had.

Please discuss with Dr Lim any plans for significant weight loss — he may recommend you stabilise your weight before undergoing surgery. A second consultation (at no extra cost) is usually required if you wish to proceed with surgery.

Avoid products that contain aspirin, vitamin E, glucosamine, herbal supplements, fish oil and krill oil for four weeks before surgery. We also strongly recommend avoiding alcohol, and not smoking for four to six weeks before and after surgery. Smoking can negatively affect the healing process.

On the day of surgery, patients should wear comfortable, loose clothing that does not need to be pulled over the head or face. Don’t wear any make-up, jewellery or nail polish.

We want to make this experience as easy as possible — you will be given all pre-operative instructions prior to your procedure but please don’t hesitate to call My Klinik if you have any questions or concerns before your surgery.

Dr Lim performs all surgeries at fully accredited hospitals — Lakeview Private Hospital and Westmead Private Hospital. Surgery for gynaecomastia is performed under general anaesthetic and you may have to stay overnight.

Please contact the hospital a day before surgery to confirm your admission and fasting time. On entering the hospital, you need to report to the admissions desk and the staff will direct you through the admission process. Dr Lim and the anaesthetist will both see you prior to surgery and Dr Lim will make some markings on your body.

After the procedure, you will spend some time in the recovery room where you will be closely monitored until you are fully awake and returned to your rooms. You will have an elastic bandage or compression garment around your chest and you may have surgical drains on both sides to drain away fluid that may accumulate.

You will have calf compressors (inflatable devices) and TED or compression stockings on both legs, as well as anticoagulant injections to reduce the risk of blood clots/deep vein thrombosis. You will have a drip in your arm and be connected to a machine to give you pain relief, fluids and medication.

The first days after surgery are usually the most uncomfortable and painful, particularly when you are moving around or coughing. Like most operations, it is not painless; you will be prescribed pain medication during this period and Dr Lim will provide a prescription for you upon discharge. It is normal to feel tired and a little slow for a day or two following a general anaesthetic.

You will have dressings over your incisions and will be able to shower 48 hours after surgery. Your bruising will subside over the next two weeks, while swelling will take longer to go down. Avoid straining, bending and lifting during this time as these activities may increase swelling or cause bleeding. You will need to wear a compression vest day and night for the first three weeks and then at night for a further three weeks — Dr Lim will advise you on this.

While Dr Lim does his best to minimise scarring, it is an inevitable part of surgery. Scars will be red and raised for several months but will flatten and fade over time.

Everyone is different, so the recovery period following this procedure varies from person to person — most patients are back to their normal routine within a few weeks.

You will be encouraged to begin walking around on the day of your surgery. Avoid strenuous exercise or heavy lifting for six weeks and avoid sporting activities for four to six weeks.

Returning to work depends on the demands of your job — you may be able to return to light work within one to two weeks. Dr Lim will discuss your individual situation with you before and after your surgery.

We endeavour to make sure our patients are as informed as possible. While some of the potential risks seem frightening, it is important for you to be aware that they can occur. Fortunately, significant complications from male breast reduction surgery are infrequent. During consultation, Dr Lim will take you through the risks involved.

Some of the possible complications are:

  • Infection
  • Temporary or permanent loss of sensation in the nipple and areola
  • Temporary or permanent skin discolouration and pigmentation changes
  • Accumulation of blood (haematoma)
  • Partial or total loss of nipple and areola tissue
  • Keloids and hypertrophic (or raised) scars
  • Another procedure may be required to remove excess skin.

While you will be slightly swollen following the surgery and it may take a few months to see the ultimate result, the benefits will be obvious straightaway.

Your chest shape will continue to be affected by the changes that ageing, weight loss and weight gain can produce in all men.

Recurrence of breast growth after surgery is possible if breasts are not fully developed — it is advised that younger men or boys wait until developed before undergoing surgery. Please ask Dr Lim if you have any concerns.

Dr Lim will monitor your progress carefully and our staff will stay in contact with you during the post-operative period. You will be seen at frequent intervals over the first six months.

Your relationship with Dr Lim and the nursing staff does not end once you have had the procedure. If you have any questions or concerns after your operation, you are always welcome to call My Klinik.

Male Breast Reduction Videos

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Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.